Significance of serum levels of VEGF, PLGF, and RAS in early screening of preeclampsia

Abstract

Objective To compare serum levels of vascular endothelial growth factor (VEGF), placental growth factor (PLGF), and renin angiotensin system (RAS) between normal pregnancies and preeclampsia pregnancies in order to provide a basis for the diagnosis of preeclampsia. Methods Sixty cases of pregnant women hospitalized at the Second Department of Obstetrics of Tai′an Central Hospital from January to December 2015 were chosen, and their gestational weeks were between 34 and 40 weeks. There were 30 pregnant women with preeclampsia (17 cases of mild preeclampsia and 13 cases of severe preeclampsia) and 30 cases of normal pregnancy. Serum VEGF, PLGF, and RAS were detected by enzyme linked immunosorbent assay (ELISA). The t-test was used to compare the VEGF and PLGF levels between two groups of pregnant women before and after delivery and the VEGF and PLGF levels, Ang (1-7), AngII, and fetal umbilical artery S/D and RI values among pregnant women with different degrees of preeclampsia. The relationship of serum Ang (1-7) and AngII with the fetal umbilical artery S/D and RI values was investigated by Spearman correlation analysis. Results Before delivery, serum VEGF and PLGF levels were significantly lower in the preeclampsia group than in the normal control group [(101.69±10.13) pg/mL vs (119.87±31.67) pg/mL, t=3.232, P<0.001; (183.57±11.38) pg/mL vs (213.78±49.06) pg/mL, t=3.554, P<0.001], and in the severe preeclampsia group than in the mild preeclampsia group [(13.86±1.17) pg/mL vs (36.91±3.35) pg/mL, t=34.432, P<0.001; (8.99±1.74) pg/mL vs (23.37±4.50) pg/mL, t=17.631, P<0.001]. After delivery, serum VEGF and PLGF levels did not differ statistically between the preeclampsia group and normal control group (t=0.061, P=0.961; t=0.133, P=0.902), and between the severe preeclampsia group and mild preeclampsia group (t=0.892, P=0.381; t=0.721, P=0.473). The levels of Ang (1-7) and AngII in the preeclampsia group were significantly lower than those of the normal control group (0.81±0.46 vs 1.49±0.57, t=5.491, P<0.001; 0.80±0.11 vs 0.89±0.19, t=2.432, P=0.012). The fetal umbilical artery S/D and RI values in the preeclampsia group were significantly higher than those of the normal control group (2.71±0.40 vs 2.16±0.38, t=6.305, P<0.001; 0.78±0.10 vs 0.57±0.08, t=6.914, P<0.001). Serum Ang (1-7) level was positively correlated with fetal umbilical artery S/D and RI values (r=0.681, P=0.012; r=0.704, P=0.008). Serum AngII level was negatively correlated with fetal umbilical artery S/D and RI values (r=-0.792, P=0.001; r=-0.783, P=0.002). Conclusion The monitoring of VEGF, PLGF, and RAS levels during pregnancy can effectively predict preeclampsia. Key words: Vascular endothelial growth factor; Placental growth factor; Renin angiotensin system; Preeclampsia; Diagnosis